HARYANA STAFF SELECTION COMMISSION

One Time Registration Details CET-'C'-01/2025

Acknowledgement

CET-'C' ID 2025
587845

Full name as per matriculation HEMLATA

Father's name SANJAY

Mother's name REKHA

Date of birth as per matriculation 08-03-2005

Gender FEMALE

Marital status UNMARRIED

Email ID attrilavi17@[Link]
Mobile No. 8307859374
Aadhaar number 799886128784
Identification marks 1 A MOLE ON FACE
Identification marks 2 A MOLE ON NACK
Have you participated in the CET 01/2022 YES
Previous CET 01/2022 Details
Registration No. as per previous CET 01/2022 587845
DOB as per previous CET 01/2022 2005-03-08
CET marks as per previous CET 01/2022 36.9873705
Category as per previous CET 01/2022 GEN
Form filled by candidate
Have you filled the form by yourself? YES
Address Information

Correspondence Address Permanent Address

Address VILL BHARATGARH Address VILL BHARATGARH
BHARATGARH URF SEHDEV BHARATGARH URF SEHDEV
Village/City/Sector Village/City/Sector
KA NANGLA 108 KA NANGLA 108
Post office HASSANPUR Post office HASSANPUR
State HARYANA State HARYANA
District PALWAL District PALWAL
Pin code 121107 Pin code 121107

Signature of the Candidate

 HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025

Category Information
Are you a Domicile/ Bonafide resident of Haryana ? YES
Domicile certificate number HR/2024/24998
Domicile certificate issue date 2024-12-19
Domicile certificate issuing authority name TEHSILDAR PALWAL,PALWAL
Category GEN
Have you worked or presently working on
adhoc/contract/workcharged/ daily wages basis in any
Department/ Board Corporation of Haryana Government NO
including Government-aided lnstitutions under Haryana
Government ?
Are you an Ex-Serviceman/Family Member of Ex-
NO
Serviceman?
Are you a dependent of freedom fighter (DFF)? NO
Are you a PWD (Person with Benchmark Disability)
NO
Candidate
Are you an eligible sports person (ESP)? NO
Do you have any criminal case against you? NO
Education Qualification
% of
Examination Course Board/university Year of
Duration Stream Rollno Marks/
Passed Type Name passing
CGPA
BOARD OF
10TH
SCHOOL
10TH - - WITH 2020 1020575754 75.4
EDUCATION
HINDI
HARYANA
BOARD OF
12TH SCHOOL
- - ARTS 2022 3022360356 84.2
COMPLETED EDUCATION
HARYANA
Payment Details
Transaction ID Paid Amount Date & Time
134314351 250 11/06/2025 [Link]

Uploaded Documents

Signature of the Candidate

 HARYANA STAFF SELECTION COMMISSION
One Time Registration Details CET-'C'-01/2025

• Photo Uploaded
• Signature Uploaded
• Aadhaar Uploaded
• Undertaking as per annexure -VII Uploaded
• Domicile Certificate Uploaded
• 10th or Matriculation certificate Uploaded
• 12th completed Uploaded
Declaration
I declare that all the information and particulars filled in this application are true, complete, and correct to the
best of my knowledge and belief. I understand that any misrepresentation, omission or concealment of facts
may lead to the cancellation of my candidature at any stage of the recruitment process or termination of my
employment, if appointed
Acknowledgement Generated Date &
Uploaded Signature
Time

11-06-2025 [Link]

Signature of the Candidate